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Monday, July 13, 2009

The pain of childbirth may have benefits on which women who opt for painkilling epidurals miss out, a senior male midwife has said.

Dr Denis Walsh, associate professor in midwifery at Nottingham University, said pain was a "rite of passage" which often helped regulate childbirth.

He said it helped strengthen a mother's bond with her baby, and prepared her for the responsibility of motherhood.

But an obstetrician said epidurals were an important option for some women.

Dr Walsh, who wrote on the subject in the journal Evidence Based Midwifery, agreed that in some cases epidurals were very useful.

But he said epidural rates had been rising over the last 20 years, despite the fact that alternative, less invasive ways to manage pain in labour were available.He said pain in labour was known to have positive physiological effects, such as helping to establish a rhythm to childbirth.

It also triggered the release of endorphins which helped women to adjust to pain.

Dr Walsh said epidurals were known to increase the risk that hormone treatment would be needed to boost contractions, and that devices such as forceps would be needed to complete the birth successfully.

He said: "I am concerned that if we increase epidural rates we do not know the long-term impacts of that."

But he warned that a culture had emerged where most hospitals effectively offered women epidurals on demand.Official figures show the number of mothers receiving an epidural rose from 17% in 1989 to 1990 to 33% in 2007 to 2008.

Dr Walsh said the NHS should encourage alternative ways to deal with pain such as yoga, hypnosis, massage and birthing pools.

Wednesday, May 20, 2009

Stress is your body's natural response to events that make you feel threatened or upset. In small doses it can be helpful making you feel focused and alert. At some point however it stops being helpful and begins to damage your health, your emotions and your quality of life. Studies have also proved that as early as 17 weeks into a pregnancy stress hormones in the mother are passed into the amniotic fluid; this means that when you are feeling stressed your baby is too.

It's very important therefore to remain as stress free as possible during pregnancy - eliminating sources of stress, and when this is not possible learning how to cope with it. The first step is learning to recognise the symptoms of stress and this can sometimes be difficult because the signs mirror some of the normal complaints of pregnancy. Symptoms might include: being quick to anger; nail biting; being unable to concentrate; loss of appetite; skin problems; frequent coughs and colds; indigestion; tense muscles; headaches and rapid heartbeat.

If you think you are suffering from stress, talk to someone! This could be your partner, family, friends or your midwife. Sometimes just getting it out into the open can be extremely helpful.There are many ways to combat stress, here are just a few:

Eat regularly and healthily - both you and your baby will benefit from healthy nutritious food. During times of stress it's easy to forget to eat or to reach for the junk food, but the food you eat can have a direct affect on your mood. Stress busting foods include bananas, broccoli, avocados, citrus fruits and whole grain breads, pasta and rice. Try to avoid caffeine too.

Take regular, gentle exercise -this helps to get rid of stress hormones such as adrenaline from your body whilst encouraging the production of endorphins, the "feel good" hormones. Swimming and walking are both ideal during pregnancy. Exercise benefits both your physical and mental health but remember to always consult your doctor before starting an exercise programme.

Try relaxation techniques - yoga, meditation and visualisation are all good. Practicing every day will help to calm you, and make you less susceptible to stress.

Listen to relaxation music -This is a quick, cheap and effective way to beat stress. Pick something that you enjoy listening to, preferably with a tempo of around 60 bpm. Clinical trials in Taiwan showed that mums to be who listened to relaxing music during their pregnancies showed a marked decrease in stress, anxiety and depressive symptoms.

Get enough good quality sleep -try to get into a good bedtime routine - going to bed at roughly the same time each night, having a relaxing bath before bed, and making your bedroom as calming as possible. Try to avoid eating too soon before bedtime as this can increase the chances of heartburn.

Take some time out - call a friend; go for a walk somewhere beautiful; paint your nails; watch a funny film or have a massage - any of these will help you to put your worries into perspective, and pregnancy is the perfect time to pamper yourself.

Hope this will help you to eliminate some stress during you pregnancy and remember all you need is to adopt a positive attitude and keep learning.

Thursday, January 1, 2009

Ah, the radiance of pregnancy: With new curves, a glowing complexion, and thick, lustrous hair, there are plenty of changes to celebrate during those nine transitional months. For many women, though, the transformation becomes a double-edged sword as the scale registers a steady weight increase. While it’s perfectly normal—and healthy—to pack on some extra pounds during pregnancy, the combination of a heartier appetite and higher levels of fatigue can make it all too easy to gain too much, making it difficult to regain your pre-baby body after delivery. Fortunately, there are some smart strategies to help you stay fit, active, and healthy while expecting. Incorporating these tips into your daily routine will not only make it easier to lose your baby weight, they’ll also help to ensure an easier labor and a quicker recovery.

Get moving! Pregnancy takes a lot out of you. Especially during the first trimester, it can be tempting to come home after a long day and head straight for the couch. Although rest is important, so is maintaining a healthy level of activity. Plan a regular exercise routine—most doctors recommend at least 30 minutes a day, 4-7 days a week—and stick to it. Some examples of safe workouts include brisk walking, water aerobics, elliptical training, and stationary cycling. In addition to burning calories, moderate cardio workouts help to decrease bloating, promote digestive health, reduce aches and pains, and improve your overall sense of well-being. Be sure to check with your doctor or midwife to make sure there are no mitigating factors that may prevent you from participating in a regular fitness regimen.

Do what you did before. While pregnancy isn’t the time to embark on a radical new activity, you don’t necessarily have to curtail the ones you enjoyed prior to conception. For instance, if you were a regular runner before getting pregnant, you should be able to continue a moderate running schedule, at least during the first and second trimesters. As always, listen to your body: any pain should be construed as a sign to slow down or take a break.

Avoid high-impact activities. The previous rule does have some exceptions. There are certain high-risk activities and contact sports, such as horseback riding, skiing, tennis, soccer, and hockey, which should be avoided during your baby’s development. Scuba diving is also a no-no, as the high water pressure can impact the fetus.

Add some strength training. You’ll get more out of your cardio workout if you target core muscle groups with some light weight resistance training. If you haven’t lifted weights before, start light—get a pair of 5 or 10 lb. dumbbells and use them to work your biceps, triceps, shoulders, quads, and calves. Search the Internet for some introductory routines that are safe during pregnancy. Most doctors recommend refraining from any exercises that call for lying on your back during the third trimester, as these can inhibit the flow of blood and oxygen to the fetus.

Warm up and cool down. Especially during pregnancy, starting or stopping an exercise too abruptly can be a shock to your system. To help prevent injury, ease into a workout with a few minutes of light stretching and walking. Cooling down with more of the same afterward will help speed up recovery and prevent muscle tightness.

Drink plenty of fluids. This is an all-day rule, although it especially applies during exercise to prevent the body from overheating. Strive for drinking eight glasses of water or juice per day. Staying hydrated is more important than ever when you’re supporting a growing fetus.

Know the warning signs. When exercising during pregnancy, it’s more important than ever to heed your body’s cues to slow down or stop. Signals that should never be ignored include chest pain, vaginal bleeding or leakage, and faintness or dizziness. While pregnant, you shouldn’t exercise to the point of exhaustion of discomfort. Periodically during your workout, pause and check for fetal movement. If you ever note a marked decrease in movement, contact your doctor or midwife.

Eat right. Your appetite may be bigger than ever, with your growing baby requiring approximately 500 additional calories per day, but that doesn’t mean you should indulge in greasy fast foods, sweets, or three helpings of whatever’s for dinner. Eating unhealthy foods can make you feel sluggish, lethargic, and can cause indigestion and heartburn. Plan a nutritious, well-balanced diet consisting of proteins, carbohydrates, and healthy fats. Be sure your menu includes lean meats, leafy vegetables, and fruits. There are certain foods, such as tuna fish and raw eggs, that should be limited during pregnancy. Check with your doctor for nutritional advice.

Join other mommies-to-be. If you’re having trouble getting motivated to exercise regularly, consider joining a fitness program designed for expectant mothers. Check your local gym or YMCA for pregnancy yoga, spinning, Pilates, and other classes. Working out with other moms-to-be can help reduce any anxiety or insecurity about your changing physique, and it’s a great way to make new friends at your same stage of life.

Look for opportunities to move. At the mall, intentionally park farther than you usually would to allow for a brisk 5-minute walk. Opt for the stairs rather than the elevator. Instead of sending a co-worker an email, walk across the office for a face-to-face chat. Over the course of the day, several of these mini-exercises can add up to significant calorie burning.

Monitor your weight. Although it’s not healthy to become obsessed with the scale, it is a good idea to keep track of the amount you’ve gained over the course of your pregnancy. Your doctor or midwife can help you identify a recommended amount of total weight gain for your body type. Substantially exceeding that amount can result in a more difficult pregnancy and labor, as well as a slower recovery period and a bigger challenge to lose the weight after baby’s arrival.

Following these tips will help you stay healthy and fit during pregnancy, allowing you to revel in your changing body rather than agonize about it.

Sunday, December 28, 2008

This is a must read article that appeared at WSJ, just wanted to share it with you.

This time of year, some hospitals see a small uptick in baby deliveries thanks to families eager to fit the blessed event in around holiday plans or in time to claim a tax deduction. Conventional wisdom has long held that inducing labor or having a Caesarean section a bit early posed little risk, since after 34 weeks gestation, all the baby has to do was grow.

But new research shows that those last weeks of pregnancy are more important than once thought for brain, lung and liver development. And there may be lasting consequences for babies born at 34 to 36 weeks, now called "late preterm."

A study in the American Journal of Obstetrics and Gynecology in October calculated that for each week a baby stayed in the womb between 32 and 39 weeks, there is a 23% decrease in problems such as respiratory distress, jaundice, seizures, temperature instability and brain hemorrhages.

A study of nearly 15,000 children in the Journal of Pediatrics in July found that those born between 32 and 36 weeks had lower reading and math scores in first grade than babies who went to full term. New research also suggests that late preterm infants are at higher risk for mild cognitive and behavioral problems and may have lower I.Q.s than those who go full term.

What's more, experts warn that a fetus's estimated age may be off by as much as two weeks either way, meaning that a baby thought to be 36 weeks along might be only 34.

The American College of Obstetricians and Gynecologists, the American Academy of Pediatrics and the March of Dimes are now urging obstetricians not to deliver babies before 39 weeks unless there is a medical reason to do so.

"It's very important for people to realize that every week counts," says Lucky E. Jain, a professor of pediatrics at Emory University School of Medicine.

It's unclear how many deliveries are performed early for nonmedical reasons. Preterm births (before 37 weeks) have risen 31% in the U.S. since 1981 -- to one in every eight births. The most serious problems are seen in the tiniest babies. But nearly 75% of preterm babies are born between 34 and 36 weeks, and much of the increase has come in C-sections, which now account for a third of all U.S. births. An additional one-fifth of all births are via induced labor, up 125% since 1989.Join a Discussion

Are parents too eager to induce labor or schedule an early C-section for sheer convenience? Are doctors too willing to go along? Share your views.

Many of those elective deliveries are done for medical reasons such as fetal distress or pre-eclampsia, a sudden spike in the mother's blood pressure. Those that aren't can be hard to distinguish. "Obstetricians know the rules and they are very creative about some of their indications -- like 'impending pre-eclampsia,'" says Alan Fleischman, medical director for the March of Dimes.

Why do doctors agree to deliver a baby early when there's no medical reason? Some cite pressure from parents. "'I'm tired of being pregnant. My fingers are swollen. My mother-in-law is coming' -- we hear that all the time," says Laura E. Riley, medical director of labor and delivery at Massachusetts General Hospital. "But there are 25 other patients waiting, and saying 'no' can take 45 minutes, so sometimes we cave."

There's also a perception that delivering early by c-section is safer for the baby, even though it means major surgery for the mom. "The idea is that somehow, if you're in complete control of the delivery, then only good things will happen. But that's categorically wrong. The baby and the uterus know best," says F. Sessions Cole, director of newborn medicine at St. Louis Children's Hospital.

He explains that a complex series of events occurs in late pregnancy to prepare the baby to survive outside the womb: The fetus acquires fat needed to maintain body temperature; the liver matures enough to eliminate a toxin called bilirubin from the body; and the lungs get ready to exchange oxygen as soon as the umbilical cord is clamped. Disrupting any of those steps can result in brain damage and other problems. In addition, the squeezing of the uterus during labor stimulates the baby and the placenta to make steroid hormones that help this last phase of lung maturation -- and that's missed if the mother never goes into labor.

"We don't have a magic ball to predict which babies might have problems," says Dr. Cole. "But we can say that the more before 39 weeks a baby is delivered, the more likely that one or more complications will occur."

In cases where there are medical reasons to deliver a baby early, lung maturation can be determined with amniocentesis -- using a long needle to withdraw fluid from inside the uterus. But that can cause infection, bleeding or a leak or fetal distress, which could require an emergency c-section.

Trying to determine maturity by the size of the fetus can also be problematic. Babies of mothers with gestational diabetes are often very large for their age, but even less developed for their age than normal-size babies.

Growing beyond 42 weeks can also pose problems, since the placenta deteriorates and can't sustain the growing baby.

Making families aware of the risks of delivering early makes a big difference. In Utah, where 27% of elective deliveries in 1999 took place before the 39th week, a major awareness campaign has reduced that to less than 5%. At two St. Louis hospitals that send premature babies to Dr. Cole's neonatal intensive-care unit, obstetricians now ask couples who want to schedule a delivery before 39 weeks to sign a consent form acknowledging the risks. At that point, many wait for nature to take its course, says Dr. Cole.

Wednesday, December 24, 2008

Having a general view of your pregnancy is a better way to avoid some of the complications that can have a catastrophic end for you and your baby's health.

The vast majority of births take place so perfect and without any incident.

However, understanding the main complications of pregnancy can be reassuring and most importantly, helps to understand all the problems calmly to resolve as quickly as possible.

Miscarriage

A miscarriage is to lose your baby before the 28th week. From 3 months, the risk of miscarriage has virtually disappeared.

Today, doctors have effective means to control and prevent this risk.

Detected early, the threat of miscarriage is closely monitored and in most cases resulted in a happy ending.

How to recognize a risk of miscarriage?

Constant bleeding and painful (pain identical to the rules) in the lower abdomen are signs that should alert you.

Consult your doctor immediately, it will recommend the rest (often, some women spend 3 / 4 of their pregnancy in bed which can seem unbearable. However, the game does not worth the candle?)

When the bleeding stops, the risk of miscarriage is rejected.

For the rest of your pregnancy, you are advised to remain vigilant and to allow the maximum.

The premature birth

Giving birth at 8th months is safe for your baby. It is said that at this stage your pregnancy is in term.

However, before that birth date (from 6th to 8th month) can lead to many complications for your child who has missed time to grow.

Even if the current medicine reaches can keep them alive in early premature birth (6 months), they often retain the legacy of this venue in the world too fast.

Accordingly, it is important to recognize the warning signs of premature delivery.

One major sign is the emergence of contractions your stomach is hard as "concrete" (contractions may be accompanied by pain) at regular intervals.

In this case, you should also tell your doctor to prescribe you the appropriate treatment and rest.

The Rhesus

This complication will not be a great development because it is detected during your 1st laboratory analysis.

Indeed, tests analyze your blood. If it is Rh-and the father is Rh +, you will receive the appropriate medical surveillance. This is due to the fact that a rhesus positive and negative (baby / mom can not come into contact).

Today, this complication is well known and is still treated in time therefore, do not worry!

Hope this information was useful for you and that you now know about some pregnancy complications.